The mechanisms of seepage failure in the reservoir-dam systems of the Yellow River Basin are increasingly complex, posing new challenges to safety prevention and control technologies against seepage failure. This paper reviews the research and practical progress on disaster-causing mechanisms and safety management of seepage failure in reservoir-dam systems of the Yellow River Basin, focusing on the following aspects: the evolution mechanism of seepage characteristics under seepage-stress coupling conditions in rock/soil masses, the dynamic behavior of seepage failure under coupled seepage-stress conditions in reservoir-dam systems, methods for seepage monitoring analysis and safety supervision, and risk assessment and mitigation technologies for seepage failure. Key issues urgently requiring resolution in current seepage safety research for the Yellow River Basin’s reservoir-dam systems have been identified. Future efforts should focus on developing visual experimental apparatus for studying rock/soil seepage-stress coupling, establishing a criterion system for judging seepage failure under multi-medium and multi-field coupling conditions, constructing mathematical models capable of characterizing environmental dynamics and uncertainties, and formulating a dynamic risk assessment and prevention/control framework that accounts for the variability of risk factors.